• Korean Journal of Head & Neck Oncology
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• v.26 no.1
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• pp.9-13
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• 2010

Background and Objectives : Parathyroid adenoma is a rare disease in Korea, but the incidence of parathyroid adenoma has gradually increased due to generalized measurement of serum calcium and imaging study according to wide spread public health screening program. In previous researches, the analysis of clinical aspects were insufficient due to a few cases. The purpose of this study was to assess the clinical analysis of surgically treated parathyroid adenoma with hyperparathyroidism. Methods : We reviewed the medical records of nineteen cases of parathyroid adenoma with hyperparathyroidism. Initial symptom to visit hospital, hypercalcemia associated medical symptom, surgical outcome and complication were investigated. Serum total calcium, parathyroid hormone, phosphate, alkaline phosphatase were checked before and after surgery. Imaging study was performed with combination of radionuclide parathyroid scan, ultrasonography and neck CT scan. Results : The initial symptoms were no symptom(6/19), pelvic pain(5/19), muscular weakness (3/19), bone pain(3/19) and palpable neck mass(2/19) in order of frequency. Serum total calcium, parathyroid hormone decreased and phosphate increased after surgery than before surgery statistically significantly. Sensitivities of parathyroid scan, neck ultrasonography and neck CT as preoperative localization test were 88.2%, 72.7%, 73.3% each. The most common postoperative complication was transient hypocalcemia(9/19). Conclusion : Similar to previous study, parathyroid adenomas have numerous clinical features and surgical treatment via unilateral approach with preoperatively localized single parathyroid adenoma was successful. In our study, parathyroid adenoma was predominantly detected by elevated serum calcium level with no clinical symptom so we need to evaluate parathyroid adenoma, if serum calcium elevated.

• Korean Journal of Head & Neck Oncology
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• v.17 no.1
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• pp.13-18
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• 2001

Objectives: We studied what is the role of elective carotid artery resection in the management of advanced cervical metastatic cancer. Materials and Methods: 5 patients with elective carotid artery resection in advanced metastatic cervical cancer were reviewed retrospectively. The patients underwent complete neuroradiologic evaluation, including CT/MRI. angiography, duplex doppler, balloon occlusion test with EEG, and brain SPECT for determination of compatible collateral circulation after carotid artery resection. Results: Perioperative complication were appeared in 2 patients those were middle cerebral arterial infarction and mediastinal bleeding. Postoperative mortality rate was 20%. 4 patients recurred within 1 year. Conclusion: Preoperative collateral study rarely provide whether resection carotid artery or not. Elective carotid artery resection cannot provide locoregional control of tumor and don't promote survival.

• Korean Journal of Head & Neck Oncology
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• v.37 no.2
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• pp.97-100
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• 2021

Pilomatricoma(or calcifying epithelioma) is a not common benign solitary tumor originated from outer root sheath cell of hair follicle or hair follicle of sebaceous glands. The tumor usually presents as an asymptomatic, hard, superficial located, and skin colored to reddish blue cutaneous mass. Most of the tumors are less than 10mm in diameter and adherent to the skin. Recently, 48-year-old man presented with cheek mass. The tumor was 2.6cm sized and located at the subcutaneous layer of cheek on CT scan. The tumor was clearly removed via transoral approach with buccal incision leaving no wound on face. The mass was confirmed as pilomatricoma on pathologic examination. Herein, we report our experience with literature review.

• Kosin Medical Journal
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• v.33 no.3
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• pp.454-462
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• 2018

A 54-year-old man, suffering from severe headache and ophthalmoplegia after undergoing endoscopic sinus surgery was referred to a tertiary hospital. Computed tomography (CT) revealed soft tissue density lesions in the left sphenoid sinus. The internal carotid artery was shown to be occluded in brain magnetic resonance imaging (MRI) scans without any other cerebral lesion. Endoscopic view of left nasal cavity shows whitish hyphae in the ethmoid and the sphenoid sinuses. We diagnosed him with cavernous sinus syndrome caused by mucormycosis and conducted endoscopic sinus surgery to remove remaining lesions and decompress orbit and optic nerves. After the revision surgery the patient's headache and ophthalmoplegia were improved. However, multifocal cerebral infarctions were newly discovered in a postoperative CT scan. We experienced a case of mucormycosis of sphenoid sinus resulting in occlusion of internal carotid artery and multifocal cerebral infarction, and report it with a brief review of these disease entities.

• Korean Journal of Radiology
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• v.23 no.2
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• pp.264-270
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• 2022

Objective: This study aimed to investigate the usefulness of bone single-positron emission tomography/computed tomography (SPECT/CT) of the hip in predicting the later occurrence of avascular necrosis (AVN) after slipped capital femoral epiphysis (SCFE) or femoral neck fracture in pediatric patients. The quantitative parameters of SPECT/CT useful in predicting AVN were identified. Materials and Methods: Twenty-one (male:female, 10:11) consecutive patients aged < 18 years (mean age ± standard deviation [SD], 11.0 ± 2.7 years) who underwent surgery for SCFE or femoral neck fracture and postoperative bone SPECT/CT were included. The maximum standardized uptake value (SUV), mean SUV, and minimum SUV of the femoral head were measured. The ratios of the maximum SUV, mean SUV, and minimum SUV of the affected femoral head to the contralateral side were determined. Patients were followed up for > 1 year after the surgery. The SPECT/CT parameters were compared between patients who developed AVN and those who did not. The accuracy of SPECT/CT parameters for predicting AVN was assessed. Results: Six patients developed AVN. There was a significant difference in the ratio of the mean SUV among patients who developed AVN (mean ± SD, 0.8 ± 0.3) and those who did not (1.1 ± 0.2, p = 0.018). However, there were no significant differences in the ratios of the maximum and minimum SUV between the groups (all p = 0.205). For the maximum, mean, and minimum SUVs, no significant differences were observed between the groups (p = 0.519, 0.733, and 0.470, respectively). The cutoff mean SUV ratio of 0.87 yielded a 66.7% sensitivity and 93.2% specificity for predicting AVN. Conclusion: Quantitative bone SPECT/CT is useful for evaluating femoral head viability in pediatric patients with SCFE or femoral neck fractures. Clinicians should consider the high possibility of later AVN development in patients with a decreased mean SUV ratio.

• Korean Journal of Head & Neck Oncology
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• v.34 no.1
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• pp.21-27
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• 2018

Background/Objectives: This study aimed to evaluate the changes of uptake around the sternoclavicular joint (SCJ) according to 18F-FDG PET images in patients with head and neck cancer who underwent neck dissection. Materials & Methods: Retrospectively, the medical records of patients who received selective or comprehensive neck dissection were reviewed. Preoperative and 1-year postoperative 18F-FDG PET images, if available, were analyzed by nuclear medicine physicians in both qualitative and quantitative manners. Correlation between the changes of uptake around SCJ and perioperative data were statistically analyzed. Results: Thirty-seven patients satisfying the inclusion criteria were enrolled. Seven patients with increased uptake around SCJ on 1-year postoperative 18F-FDG PET showed a correlation with radical or comprehensive neck dissection, accessory nerve sacrifice, and high postoperative SUVmax. When 20 patients with increased uptake around SCJ according to quantitative measurement were compared with other patients without increased uptake, no parameter was significantly different, except postoperative SUVmax. Bivariate logistic regression analysis revealed that the clinical symptom (shoulder or sternal pain) was significantly correlated with the extent of neck dissection (OR 0.227, CI 0.053-0.966, p=0.045) and spinal accessory nerve sacrifice (OR 13.500, CI 1.189-153.331, p=0.036). Conclusions: Increased uptake around SCJ on 1-year postoperative 18 F-FDG PET was correlated with either the radical or comprehensive procedure, as well as with accessory nerve sacrifice. This suggests that subjective analysis of 18F-FDG PET can be used to detect subclinical shoulder instability.

• Korean Journal of Bronchoesophagology
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• v.6 no.1
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• pp.16-20
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• 2000

The patient a 24-year-old male, was shown to have milliary shadows on chest radiographs from the age of 20. He was temporarily treated for pulmonary tuberculosis without success. He had left thyroid mass and lymph node metastases in neck CT scan which was taken after admission but fine needle aspiration result in scanty cellularity. He underwent total thyroidectomy with left modified radical neck dissection and right selective neck dissection under the impression of differentiated thyroid cancer with bilateral neck metastases. Then he underwent 131I ablation treatment and postoperative whole body 131I scintigraphy revealed diffuse intensive uptake in the bilateral lung fields, demonstrating that the pulmonary lesions were metastases of the thyroid cancer.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.31 no.2
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• pp.178-182
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• 2005

With the development of systemic diagnostic technique in cancer, the diagnostic methods of head and neck region are developing, also. Now, it is usually used computed tomography(CT), magnetic resornance image(MRI) in head and neck cancer and positron emission tomography(PET) is being increased in diagnostic use because of tumor specificity and accuracy. However, CT and MRI show the advantage of showing precise anatomical landmarks, but the disadvantage of these methods is much affecting by anatomical variations and changes. Otherwise, PET presents the imaging of physiologic and biochemical phenomenon and the disadvantage is the difficult differentiation of normal physiologic uptake, the lack of normal anatomical landmarks. PET/CT, the combination of clinical PET and CT imaging in a single unit is introduced recently, and it helps to get more accurate diagnostic interpretation and to improve in evaluating response to therapy, in management of patients with malignant tumors. So, we report the advantages of PET/CT in the diagnosis of oral cancer with review of literatures.

• Korean Journal of Head & Neck Oncology
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• v.33 no.1
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• pp.85-89
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• 2017

A 62-year-old female patient had goiter for twenty years. She visited out-patient clinic with a hoarse voice and intermittent breathing difficulties. About protruding 15cm sized mass located the anterior neck and right vocal cord paralysis was observed. Preoperative CT scan was strongly suspected of thyroid gland cancer and cervical lymph node metastasis. Therefore, fine needle aspiration test was performed and surgical treatment was planned with the histopathologic results (papillary thyroid carcinoma). Surgery was performed with total thyroidectomy, bilateral cervical lymph node dissection, and right selective nodal lymph node dissection (level II-V). During operation right thyroid seemed to be adherent to surrounding tissue and the blood vessels were extremely engorged. There was hypotensive crisis because of intraoperative excessive bleeding. However it was managed by repetitive transfusion. The operation was completed without abnormalities. She underwent 4 times of bleeding control operation due to postoperative bleeding. After complications were improved, we are currently undergoing out-patient follow up without morbidity.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.26 no.2
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• pp.127-129
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• 2015

Background and Objectives : The etiology of globus pharyngeus remains uncertain. It has been known there is a relationship between the presence of air bubbles in esophagus and GERD symptoms. The aim of this study is to identify relationship between the globus symptom and the presence of air column in esophagus. Subjects and Methods : The study population consisted of 46 patients who underwent CT scan as part of evaluation for globus. Controls were chosen from the population consisted of patients with lymphadenopathy who underwent CT scan. The correlation between the presence of globus symptom and diameter, volume, and position of the air column was assessed using t-test. Reproducibility of diameter and volume of the esophageal air column was analyzed using intraclass correlation coefficient. Results : In study group, the mean volume of the air column was $769.56{\pm}983.08mm^3$, the mean diameter was $8.24{\pm}4.90mm$, the mean distance from the inferior border of posterior lamina of cricoid cartilage was $88.86{\pm}28.01mm$. In control group, $682.18{\pm}767.28mm^3$, $8.37{\pm}5.50mm$, $88.34{\pm}21.06mm$, respectively. There were no differences of diameter, volume and distance of the air column between the two groups. We failed to obtain acceptable reliability when we compare the diameter and the volume of the esophageal air column. Conclusion : There was no relationship between air column of esophagus and presence of globus symptom. And the measurement of diameter and volume of the esophageal air column change over time and it should be considered in a further study.